This is entirely the concept of the Predictive Low Glucose Suspend which Tandem is working on. They are not alone in this of course but that is the one which we are anxiously waiting for. However that which a human can “eyeball” and see the obvious when looking at the curve of a CGM and integrate the information regarding IOB and last food intake … requires significant sophistication of computer programming.
“Our first-generation Automated Insulin Delivery (AID) system is planned to include a Predictive Low Glucose Suspend (PLGS) algorithm. The algorithm will use CGM data to help predict future hypoglycemia (low blood sugar) before it happens and is designed to adjust insulin to help minimize the frequency and or duration of hypoglycemic events. The algorithm was developed internally in consultation with thought leaders in Automated Insulin Delivery and Artificial Pancreas research.”
Medtronic already have a predictive low glucose suspend in the 640G and the 670G will include this in the Hybrid AP algorithms. What is surprising is that none of the other pump manufacturers have yet to come up with an equivalent.
Understood. However I am not willing to give up the Dexcom which I believe is superior technology just to be able to use what Medtronic has come out with first.
It is my opinion that the Tandem / Dexcom combination is simply better technology and worth waiting a little longer for.
I agree with you about the relative accuracy of the Dexcom CGM vs Medtronic’s current Enlite. What is surprising is that none of the other pump companies seem to be anywhere close to introducing a pump with low glucose suspend, never mind hybrid AP technology. If there is nothing in the pipeline, there could be several years during which Medtronic forge ahead (?690G is on the horizon) whilst their competitors are stuck in the steam age.
Tandem is publicly saying they plan to complete the work on the Predictive Low Glucose Suspend this year (2017) and have it available for consumer use early next year (2018) as a remote software update on the Tandem t:slim X2 and Dexcom G5 with no pump hardware change required for the update.
Animas is working on a semi-automated pump they are calling the Hyper-Hypo Minimizer, which I presume would have a similar feature to low glucose suspend (whether it’s predictive, I don’t know).
Ii talked to a senior Animas rep a couple of months ago. They are talking about a new pump with low glucose suspend characteristics but there are no indications as to when (or indeed if) it is likely to hit the market. Certainly not in the immediate pipeline. I imagine the uncertainty over J&J’s role in Animas is putting everything on hold.
Tandem is of no use to me as they do not sell pumps in the UK and I understand have declined to tender as an NHS-approved supplier.
Like everything else in diabetes, there are no universal rules. My results don’t match that table, and I’m willing to bet that I have plenty of company.
@Tim35 Also, xDrip+ provides a prediction algorithm which I find very useful. It displays a graph of when the expected low will occur based on the user profile and entered treatments, and will alert if that setting is enabled on predicted lows.
I use mini glucagon doses. It is out of label use, but quite popular and works very well.
I mix the glucagon from rescue kit, but I don’t use the whole vial at once, but draw with insulin syringe 5-15 units ( typically I need 10, but it depends on how bad is the low, how many units on board, what is body weight). You can keep the vial in the room temp for a while. I have it in my purse, used it after two weeks, still works fine, just added 5 units, thinking potency will be down.
A few facts to remember when using miniglucagon doses.
This is out of label use, meaning - not studied, not approved for
one day we will have glucagon in the pen, and this would be available for everyone at normal cost
Glucagon is expensive, make sure to ask your doc to prescribe 2 kits per rx, one copay per refill - two kits
IF YOU HAD ALCOHOL OR SEVERE LOW WITHIN 6-8 hours , glucagon may not work, as the liver glycogen storage are not available.
ENJOY, you can’t get less calories than that!
PLEASE REMBER, FOCUS ON PREVENTION OF HYPOGLYCEMIA FIRST! ALWAYS ASK YOURSELF QUESTION, WHY , HOW TO PREVENT NEXT TIME.
David, I agree. The degree of bg increase from one glucose tablet also depends on so many other factors, (dropping fast or a slow drop, stress-yes sometimes I go low with stress-go figure, previous exercise hitting, did I have fat slowing things down, etc.)
You asked about preventing overnight lows–on my low carb diet (under 50/day), my doc suggested a protein snack at bedtime. Proteins translate to 12% carbs, are absorbed more slowly than straight glucose, and help me feel “full”. A chunk of cheese or meat, Atkins-type shakes (15 gym pro, 8 gm carb) work well for me.
Try turning your basal off an hour before working out until an hour after, and see how well that works. You can do it by setting a temporary basal to zero, or just above zero if it won’t let you set to zero.
